patient advocate

Avera Health

<div><div><div><div><div><div><div><div><p><b>Location:
</b></p></div></div></div></div></div></div></div>Avera Cancer Institute-Sioux Falls
<p></p><p><b>Worker Type:
</b></p>Regular
<p></p><p><b>Work Shift:
</b></p>Day Shift (United States of America)
<p></p><p><b>Pay Range:
</b></p><p><i>The pay range for this position is listed below. Actual pay rate dependent upon experience.
</i></p>$20.75 - $27.50
<p></p><p><b>Position Highlights
</b></p><p>Clinic Hours: Monday - Friday, 8:00 AM - 4;30 PM<br>
</p><p></p><p><br>
<b>You Belong at Avera
</b></p><p></p><p><b>Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.<br>
</b></p><br>
<p></p><b>A Brief Overview
</b><br>
<br>
Responsible to provide assistance to patients and/or families as they navigate through all aspects of their medical paperwork, including insurance, billing, payment and collection process. This position is responsible to screen patients to determine potential for program assistance, complete application with patient and families, and follow up after discharge regarding application and maintain knowledge base of community agencies and resource to facilitate appropriate referrals, including maintaining a thorough understanding of eligibility requirements and current laws governing government programs. A successful advocate will communicate with patients, families, case managers, and providers to assess care plans and corresponding coverage needs and work in a compassionate and tactful manner to help facilitate access to and provide continuity of care. Advocates also work with other members of the care teams, insurers, financial, and administrative personnel.
<br>
<br>
<b>What you will do<br>
</b><br>
<br>
<ul><li>Insurance Screening: Obtain detailed patient insurance benefit information for all aspects of cancer care, including, but not limited to, outpatient services and prescription drugs. Verify insurance coverage and other medical benefits and acquire necessary referrals and authorizations.
</li><li>Identify self-pay patients and evaluate coverage opportunities. Assist with completion of all needed applications for coverage, including applications for drug assistance. Provide accurate cost estimate details to patients prior to appointments.
</li><li>Discuss benefits and other financial concerns with patients and/or family members during initial referral and during continuation of care. Identify and effectively communicate financial information to team members, patients, and their families with emphasis on identifying any potential patient out-of-pocket liability. Assist patients with questions concerning insurance, coverage, and other financial issues. Document in patient record as appropriate.
</li><li>Obtain all necessary insurance authorizations. Obtain clinical information as needed from the medical record to answer clinical questions during authorization process. Communicate with care team and pharmacy staff to ensure that all treatments meet medical necessity. Draft medical necessity authorization request letters to include insurance contact information, patient history, and appropriate scientific literature. Manage both routine and complex insurance authorizations directly. Responsible for the coordination of level II appeals with oversight from the appropriate medical staff.
</li><li>Work with patients, their families and team members to help address insurance coverage gaps via alternative funding options including, but not limited to, help with completing applications for copay assistance, compassionate use drug and/or Avera Patient Assistance. Assist patient and family members in completing work-related documentation including, but not limited to, FMLA, short term disability, long term disability, and work letters.
</li><li>Maintain tracking mechanisms for status of authorization requests, referrals, and drug assistance. Regularly assesses updated information regarding insurance data, authorizations, and preferred providers. Track free drug assistance to ensure patients maintain coverage when initial enrollment ends.
</li><li>Facilitate resolution of patient billing issues which may include appealing denied claims. . Work in collaboration with the patient, insurance, and business office.
</li><li>Work as a member of a team of Patient Advocates to assist in other oncology departments as needed. Work with multiple disciplines and departments to ensure clear communication and prompt delivery of treatment. Accurately document all interactions related to advocacy within the EMR.
</li></ul><br>
<b>Essential Qualifications
</b><br>
<br>
The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
<br>
<br>
<b>Required Education, License/Certification, or Work Experience:<br>
</b><br>
<br>
<ul><li>Associate's social work, coding, or a healthcare-related field and/or combination of experience and education.
</li><li>1-3 years Experience in healthcare and insurance verification.
</li></ul><br>
<b>Expectations and Standards<br>
</b><br>
<br>
<ul><li>Commitment to the daily application of Avera&rsquo;s mission, vision, core values, and social principles to serve patients, their families, and our community.
</li><li>Promote Avera&rsquo;s values of compassion, hospitality, and stewardship.
</li><li>Uphold Avera&rsquo;s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
</li><li>Maintain confidentiality.
</li><li>Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
</li>Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.<br>
<li>
</li></ul><br>
<p></p><p><b>Benefits You Need &amp; Then Some
</b></p><p></p><p>Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.
</p><ul><li><p>PTO available day 1 for eligible hires.
</p></li><li><p>Up to 5% employer matching contribution for retirement
</p></li><li><p>Career development guided by hands-on training and mentorship
</p></li></ul><p></p><p><i>Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to </i><i>talent@avera.org </i><i>.</i></p></div>

Patient Advocate

Sky Lakes Medical Center

<p>Qualifications:<br/>Required: 3 years relevant experience in clinical care setting or customer service; strong customer service skills; ability to handle difficult situations compassionately and constructively; ability to address difficult, awkward situations with tact and diplomacy; ability to manage emotions, empathize with others, and navigate interpersonal relationships effectively; excellent analytical skills, including analysis, planning, organization, and issue resolution; team player and demonstrate proven success in applying a team approach to resolve issues or accomplish goals; Ability to work with minimal supervision; ability to interact professionally and effectively in a timely manner with a wide variety of constituents, including patients, family, physicians, Sky Lakes staff, and volunteers; ability to present educational sessions for large or small groups on customer service and service recovery principles; Ability to exercise appropriate judgment even in stressful situations; and Code Gray certification by end of the month from 3 months from position start date.<br/>Preferred: Board Certified Patient Advocate credential or bachelor&rsquo;s degree with emphasis in healthcare, behavioral science, psychology, customer service or other related field.<br/></p><p>Typical Physical/Mental Demands:<br/>Must be able to sit or stand for long periods of time and be able to move to patient care areas when needed. Must be able to work under required deadlines and schedules, while being flexible to special requests and projects. Must be able to work independently, as well as with co-workers, patients, families, and physicians. Must be able to prioritize work demands and organize time efficiently. Must work well under stress.<br/></p><p>Essential Job Functions:<br/></p><p>Regularly interacts with patients, family members, physicians, leadership, hospital staff, and volunteers.<br/>Coordinates the timely response and review of patient and family concerns.<br/>Models excellent service behavior and issue resolution process.<br/>Works with staff in a supporting way to resolve issues.<br/>Maintains high visibility to staff through regular rounding.<br/>Works closely with Quality Management and Risk Management in promoting performance improvement activities and reducing hospital liability through documentation and analysis of concerns as well as prompt and caring resolution of patient and family issues.<br/>Develops a consultant relationship with all Sky Lakes departments to build and sustain a patient-focused culture, to meet customer service needs, and to improve clinical quality outcomes.<br/>Participates on committees, work groups, and process improvement teams to improve patient experience.<br/>Documents patient and visitor concerns to include synopsis of incident, actions taken to resolve, and outcome in Sky Lakes Quality Communication System.<br/>Composes letters to patients and visitors in accordance with the terms of the Sky Lakes Patient Grievance Policy and the Conditions of Participation as specified by the Centers for Medicare and Medicaid Services (CMS).<br/>Assists in development and implementation of policies and procedures.<br/>Demonstrates competence in relation to the defined mission, vision, values, and strategic plan of the organization.<br/></p><p>Marginal Job Duties:<br/></p><p>&middot; Demonstrates willingness and ability to perform additional job duties.<br/></p><p>Work Location: In person<br/></p>

Lifebridge Health

<div><h1 class="jobSectionHeader"><b>Medicaid Patient Advocate
</b></h1><div><div><ul><li>Randallstown, MD
</li><li>SINAI HOSPITAL
</li><li>Full-time - Day shift - 8:00am-4:30pm
</li><li>CLERICAL ADMIN
</li><li>96069
</li><li>$18.67-$33.17 Experience based
</li><li>Posted: Today
</li></ul></div><div>Apply Now Save Job Saved
</div></div><div><p><b>Summary</b>
</p><div><div><p><b>Who We Are:</b><br>
<br>
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to &ldquo;improve the health of people in the communities we serve.&rdquo; Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.<br>
</p><p><b>About the Role:</b></p><br>
<p></p>
<p>The Medicaid Patient Advocate will complete Medical Assistance Applications on uninsured and underinsured patients who may qualify for benefits under the Maryland Medicaid Program or other entitlement programs and will complete forms to determine Financial Assistance eligibility under LifeBridge Health policy.</p><br>
<p></p>
<p><b>KEY RESPONSIBILITIES:</b></p>
<ul><li>Completes Medicaid and Financial Assistance applications for uninsured/underinsured patients.</li>
<li>Interviews patients to determine if covered by insurance not identified at registration on date of service or within 24 hours of inpatient admission.</li>
<li>Verifies insurance coverage and updates insurance information on all accounts within eligibillity period on date of service or within 24 hours of inpatient admission.</li>
<li>Interviews uninsured/underinsured patients to determine Medicaid and Financial Assistance eligibility.</li>
<li>Utilizes software to complete and submit Medicaid applications electronically.</li>
<li>Completes and submits paper Medicaid applications when appropriate.</li>
<li>Updates system(s) with notes pertaining to actions taken/actions required.</li>
<li>Sets appropriate next activity/follow-up dates within prescribed timeframes.</li>
<li>Follows up with patients to obtain and submit required documentation to complete Medicaid application within 30 days of discharge.</li>
<li>Monitors billing of converted accounts and escalated claims not billed.</li>
<li>Makes appropriate referrals of incomplete applications at 30 days to secondary agencies.</li>
<li>Monitors Medicaid Applications.</li>
<li>Monitors submitted applications and takes appropriate action to resolve/finalize.</li>
<li>Contacts Maryland Department of Health (MDH) State Caseworkers to ascertain status of applications and resolve outstanding documentation requests.</li>
<li>Checks applicant eligibility on-line.</li>
<li>Escalates cases that are not final dispositioned within prescribed timeframes.</li>
<li>Takes necessary steps to update accounts with final Medicaid disposition.</li>
<li>Documents all relevant action taken to resolve the account.</li>
<li>Updates applicable insurance information.</li>
<li>Updates True Self Pay to accounts determined not eligible.</li>
<li>Ensures timely billing of accounts.</li>
</ul>
<p><b>REQUIREMENTS:</b></p>
<ul><li><b>Education: </b>Associate's degree preferred.</li>
<li><b>Experience: </b>Minimum three<b> </b>years of experience with any medicaid program.</li>
<li><b>Licenses/Certification: </b>Certified Application Counselor (CAC) preferred but must obtain within one year of hire. Must have full MD driver's license and reliable transportation to travel to other LifeBridge Health facilities.</li>
<li>Must have transportation to travel to other LifeBridge Health locations as needed for coverage.</li></ul><br>
<p>
</p><p>POSITION LOCATED AT NORTHWEST HOSPITAL</p><br>
<p></p>
</div>
</div><p><b>Additional Information</b><br>
</p><br>
<b>What We Offer:</b><br>
<br>
<i>Impact: </i>Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.<br>
<br>
<i>Growth</i>: Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.<br>
<br>
<i>Support:</i> A culture of collaboration with resources like unit-based practice councils and advanced clinical education support &mdash; improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.<br>
<br>
<i>Benefits</i>: Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs.<br>
<br>
<b>Why LifeBridge Health?</b><br>
<br>
With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital.<br>
<br>
Our organization thrives on a culture of CARE BRAVELY&mdash;where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.<br>
<br>
LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.
</div><div><div><div><div>Share:
</div></div><div>Apply Now</div></div></div></div><div></div>

Medicaid Patient Advocate

Knipper Health

<div>Overview:<div></div><div><b><br>
YOUR PASSION, ACTIONS &amp; FOCUS is our Strength</b></div><div><b>
Become one of our Contributors</b></div><div><b>
Join the Caretria Team!</b></div><div></div><p><br>
The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions.</p>
Responsibilities:
<p><b>
KEY RESPONSIBILITIES:
</b></p><ul><li>Review and process patients&rsquo; enrollment forms to the Patient Assistance Program (PAP)</li><li>
Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.</li><li>
Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process</li><li>
Schedule treatments to be sent to the patient or patient&rsquo;s healthcare provider</li><li>
Support inbound and outbound phone lines for the PAP program</li><li>
Communicate daily with patient/authorized representatives on eligibility based on PAP criteria and healthcare providers to manage expectations.</li><li>
Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer&rsquo;s PAP program.</li><li>
Prioritize workload to ensure patients&rsquo; enrollments are processed within specified timeframe</li><li>
Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician office staff.</li><li>
Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers.</li><li>
Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.</li><li>
Execute day-to-day operations specific to the assigned program(s).</li><li>
Always maintain patient confidentiality.</li></ul><p><b><i>
The above duties are meant to be representative of the position and not all inclusive.</i></b></p>
Qualifications:
<p><b>
MINIMUM JOB REQUIREMENTS</b><b>:</b></p><ul><li>
High school diploma or equivalent</li><li>
Kentucky Pharmacy Technician Registration<ul><li>
Kentucky requires a licensed pharmacy technician to be over the age of 18.</li></ul></li></ul><br>
<div></div><ul><li>
Two (2) years of work experience in customer service or customer focused healthcare role</li><li>
One (1) year of work experience in a HUB service or call center environment.</li><li>
Strong attention to detail and accuracy in data entry
</li><li>Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers</li><li>
Must have proven ability to provide consistently high-quality of service</li></ul><div></div><div><b><br>
PREFERRED EDUCATION AND EXPERIENCE</b><b>:</b></div><ul><li>
Education: Associate degree or completion of technical school training in healthcare, pharmacy or a related field</li><li>
Experience:<ul><li>
Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field</li><li>
Experience with HIPAA regulations and privacy standards
</li></ul></li><li>Certifications:</li></ul><p>
National Pharmacy Certification (PTCB, ExCPT) preferred</p><ul><li>
Language Skills:<ul><li>
Bilingual proficiency in English and Spanish strongly preferred
</li></ul></li><li>Prior experience in patient assistance programs and/or benefit verification processes</li></ul><p><b>
KNOWLEDGE, SKILLS &amp; ABILITIES</b><b>:</b></p><ul><li>
Demonstrated empathy and compassion</li><li>
Excellent verbal and written communication skills</li><li>
Excellent organization skills and detail oriented</li><li>
Balance multiple priorities to meet expected response deadlines</li><li>
Adaptable, flexible and readily adjust to changing situations</li><li>
Ability to work independently and as a member of a team</li><li>
Ability to comprehend and apply basic math principles</li><li>
Ability to apply logical thinking when evaluating practical problems</li><li>
Ability to present information and respond to questions from stakeholders</li><li>
Ability to interact with a diverse group</li><li>
Ability to listen and demonstrate a high degree of empathy</li><li>
Demonstrated computer skills includes Microsoft Word, Excel, and Outlook</li><li>
Display tact and diplomacy in response to unfavorable or negative situations</li><li>
Demonstrated sensitivity and understanding when speaking with patients</li><li>
Demonstrated passion for speaking with people in an outgoing way</li></ul><div><b>
PHYSICAL REQUIREMENTS</b><b>:</b></div><ul><li>
Location of job activities Remote, Hybrid or onsite; geographic location</li><li>
Extensive manual dexterity (keyboarding, mouse, phone)</li><li>
Constant use of phone for communication</li><li>
Noise and/or vibrations exposure</li><li>
Frequently reach (overhead), handle, and feel with hands and arms</li><li>
Sit for prolonged periods of time</li><li>
Occasionally stoop, kneel, and crouch</li><li>
Occasionally lift, carry, and move up to 25 pounds</li></ul><div></div><div><br>
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</div><div>
The expected base pay range for this position is $19&ndash;$24 per hour. The actual compensation for the position may vary based on market differences and on factors such as skills, experience, qualifications and can vary based on location and/or work schedule. In addition to base pay, CareTria offers a comprehensive benefits package. Full-Time benefits include access to health, dental, and vision insurance; retirement plan options; paid time off; paid parental leave; employee assistance programs; and other perks. Eligible employees may also have access to performance bonuses.</div><div>
CareTria is an Equal Opportunity Employer.</div></div>

Pharmacy Patient Advocate

Flyland Recovery Network

<p>Position Summary</p><p>The Patient Advocate serves as a bridge between patients and staff, helping to foster communication, trust, and a supportive treatment environment. This role supports patient engagement by facilitating activities such as Golden Hour and Healing Arts, encouraging connection, expression, and participation in the recovery process. The Patient Advocate listens to patient concerns and perspectives and helps communicate patient needs to the treatment team to promote a respectful and responsive care environment. The position focuses on supporting patient experience, encouraging involvement in programming, and helping individuals feel heard and supported during their time in treatment.</p><p>Key Responsibilities</p><ul><li>Advocate for patient needs in treatment planning, care delivery, and discharge planning.</li><li>Maintain confidentiality in accordance with HIPAA and 42 CFR Part 2.</li><li>Facilitate recreational and healing arts activities with patients</li><li>Support trauma-informed, culturally competent, and patient-centered care practices.</li><li>Provide input into program development to improve patient experience.</li></ul><p><b>Required Qualifications</b></p><ul><li>Associate&rsquo;s or Bachelor&rsquo;s degree in Social Work, Psychology, Public Health, Human Services, or a related field preferred.</li><li>Minimum 1&ndash;2 years of experience in patient advocacy, social work, or behavioral health.</li><li>Strong knowledge of addiction treatment and mental health care systems.</li><li>Excellent communication, problem-solving, and interpersonal skills.</li><li>Ability to handle sensitive information with confidentiality and professionalism.</li></ul><p><b>Preferred Qualifications</b></p><ul><li>Experience working in a residential or outpatient substance abuse/mental health facility.</li><li>Familiarity with Ohio state regulations regarding behavioral health services and patient rights.</li><li>Certification in Peer Support or Case Management (a plus).</li></ul><p><b>Working Conditions</b></p><ul><li>This role may involve occasional evening or weekend hours to accommodate patient schedules.</li><li>Work is performed in a clinical environment that may include inpatient or outpatient settings.</li><li>Occasional travel within the community may be required for outreach or resource coordination.</li></ul><p><b>Compensation &amp; Benefits</b></p><ul><li>Competitive salary commensurate with experience.</li><li>Health, dental, and vision insurance.</li><li>Paid time off, holiday pay, and retirement benefits.</li><li>Opportunities for professional development and continuing education.</li></ul><p>Job Type: Full-time</p><p>Pay: $19.00 - $21.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Medical Specialty:</p><ul><li>Addiction Medicine</li></ul><p>Work Location: In person</p>

Patient Advocate-Substance Abuse/Mental Health Facility

Community Health Systems, Inc.

<div><div><div><div><p>Job Title: Patient Financial Advocate Date Prepared: April 2026</p>
<div>Position: Patient Financial Advocate</div>
<p>Location: Community Health Systems, Inc. EEO Category: Administrative</p>
</div>
<div><p>Department: Revenue Cycle Non Exempt</p>
</div>
 <div><p><b>JOB SUMMARY:</b></p>
</div>
</div><div><p>Patient Financial Advocate determines appropriate sources of reimbursement for services at Community Health Systems, Inc. Assists patients based on Federal Poverty Guidelines. Meets with patients to discuss balances on accounts. Calls patients with a past due account.</p>
</div>
 <div><p><b>ESSENTIAL JOB FUNCTIONS:</b></p>
</div>
<div><ul><li><p>Analyzes outstanding balances, makes phone calls, and sends letters for collections on accounts.</p>
</li></ul></div><div><ul><li><p>Thorough documentation of all communications regarding all patient balances</p>
</li></ul></div><div><ul><li><p>Follow up on accounts receivable until balance is resolved, including payment plan monitoring.</p>
</li></ul></div><div><ul><li><p>Assists with patient calls regarding billing questions.</p>
</li></ul></div><div><ul><li><p>Assists with error resolution.</p>
</li></ul></div><div><ul><li><p>Assists Patient Financial Counselors with task work during downtime.</p>
</li></ul></div><div><ul><li><p>Collaborates with Billing staff to determine source of account balance.</p>
</li></ul></div><div><ul><li><p>Preforms end of month duties as assigned</p>
</li></ul></div><div><ul><li><p>Provides coverage for PFC/PRP positions as needed.</p>
</li></ul></div></div><div><div><ul><li><p>Attends meetings as required.</p>
</li></ul></div><div><ul><li><p>Other duties as assigned.</p>
 </li></ul></div><div><p><b>PREFERRED QUALIFICATIONS:</b></p>
</div>
<div><p><b>Skills/Abilities</b></p>
</div>
<div><ul><li><p>Be efficient, organized and set priorities to accomplish deadlines.</p>
</li></ul></div><div><ul><li><p>Have strong computer skills.</p>
</li></ul></div><div><ul><li><p>Communication and organizational skills that include tracking and reporting.</p>
</li></ul></div><div><ul><li><p>Prioritize workload proactively and expeditiously.</p>
</li></ul></div><div><ul><li><p>Knowledge of financial concepts with attention to detail.</p>
</li></ul></div><div><ul><li><p>Perform multiple tasks effectively.</p>
</li></ul></div><div><ul><li><p>Ability to work both independently and as part of a team.</p>
</li></ul></div><div><ul><li><p>Decides independently the logical next step.</p>
</li></ul></div><div><ul><li><p>Maintains information that is confidential.
</p></li></ul></div><div><ul><li><p>Bilingual preferred.</p>
 </li></ul></div><div><p><b>Education</b></p>
</div>
<div><ul><li><p>High school Diploma or equivalent required.</p>
 </li></ul></div></div><div><div><p><b>Related Work Experience</b></p>
</div>
<div><ul><li><p>2-3 years of customer service experience.</p>
</li></ul></div><div><p><b>PHYSICAL DEMANDS</b></p>
</div>
<div><p>The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p>
</div>
<div><ul><li>While performing the duties of this job, the employee is regularly required to sit; talk or hear and has substantial movements of the wrists, hands, and/or fingers.
</li></ul></div><div><ul><li><p>The employee must occasionally lift and/or move up to 10 pounds</p>
 </li></ul></div><div><p><b>WORK ENVIRONMENT</b></p>
</div>
<div><p>The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p>
</div>
 <div><ul><li>While performing the duties of this job, the employee is frequently exposed generally to good working conditions. Work may occasionally involve distasteful patient related activities.
</li></ul></div><div><div>Community Health Systems, Inc. is an equal opportunity employer.</div></div></div></div>

Patient Financial Advocate

Health Net

<div><p>You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility.<br>
</p><p><b>Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.</b></p><p><b>
** Must live in California. Telephonic member outreach.</b></p><p><b>
** Preference for Bi-Lingual Spanish.</b></p><p><b>
Position Purpose:</b><br>
Works with members and providers to close care gaps, ensure barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at large IPA and/or group practices. Serves to collaborate with providers in the field, to improve HEDIS measures and provides education for HEDIS measures and coding. Supports the implementation of quality improvement interventions and audits in relation to plan providers. Assists in resolving deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS. Conducts telephonic outreach, while embedded in the providers' offices, to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements. Provides education to members regarding the care gaps they have when in the providers office for medical appointments. Schedules doctor appointments on behalf of the practitioner and assists member with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available. Maintains confidentiality of business and protected health information.</p><ul><li>
Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.</li><li>
Acts as the face of WellCare in the provider community with the provider and office staff where their services are embedded.</li><li>
Advises and educates Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements.</li><li>
Assesses provider performance data to identify and strategizes opportunities for provider improvement.</li><li>
Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment, Operations (claims and encounters).</li><li>
Schedules doctor appointments for members with care gaps to access needed preventive care services and close gaps in care in the provider&rsquo;s office.</li><li>
Conducts face-to-face education with the member and their family, in the provider&rsquo;s office, about care gaps identified, and barriers to care.</li><li>
Conducts telephonic outreach and health coaching to members to support quality improvement, regulatory and contractual requirements.</li><li>
Arranges transportation and follow-up appointments for member as needed.</li><li>
Documents all actions taken regarding contact related to member.</li><li>
Interacts with other departments including customer service to resolve member issues.</li><li>
Refers to case or disease management as appropriate.</li><li>
Completes special assignments and projects instrumental to the function of the department. Performs other duties as assigned.</li><li>
Complies with all policies and standards.</li></ul><p><b>
Education/Experience:</b><br>
<br>
<b>Required:</b> a Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field or equivalent work experience required (a total of 4 years of experience required for the position); work experience should be in direct patient care, social work, quality improvement or health coaching preferably in a managed care environment. 2+ years of experience work experience should be in direct patient care, social work, quality improvement or health coaching preferably in a managed care environment.<br>
<br>
<b>License/Certification:</b> One of the following is preferred. Licensed Practical Nurse (LPN); Licensed Master Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse (RN) preferred.</p>
Pay Range: $27.02 - $48.55 per hour<p>
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.</p><p>
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.</p><p><br>
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act</p></div>

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